Calcaterra Valeria, Winickoff Jonathan P, Klersy Catherine, Schiano Luca Maria, Bazzano Rossella, Montalbano Chiara, Musella Valeria, Regalbuto Corrado, Larizza Daniela, Cena Hellas
1Pediatric and Adolescent Unit, Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy.
2Pediatric Endocrinology Unit, Department of Maternal and Children's Health, Fondazione IRCCS Policlinico San Matteo, P.Le Golgi n.2, 27100 Pavia, Italy.
Diabetol Metab Syndr. 2018 Jul 6;10:53. doi: 10.1186/s13098-018-0355-0. eCollection 2018.
To evaluate the relationship between smoking and metabolic parameters in patients affected by type 1 diabetes (T1D).
We enrolled 104 children and young adults (50 females and 54 males) with T1D (aged 16.4 ± 8.6 years). The subjects were divided into three groups according to their smoking habits: no smoking (NS), passive smoking (PS), active smoking (AS). The physical examination of the participants included nutritional status assessment by anthropometry and pubertal stage according to Marshall and Tanner as well as blood pressure measurement. In all patients, metabolic blood assays including fasting blood glucose, insulin, total cholesterol, high-density lipoprotein cholesterol, and triglycerides were measured. Insulin resistance was determined by glucose disposal rate (eGDR). Physical activity was also recorded.
Significant differences in biochemical and functional parameters among the three groups were demonstrated, in particular for systolic (p = 0.002) and diastolic pressure (p = 0.02) and eGDR (p = 0.039). No differences in daily insulin dose (p = 0.75) and glycated hemoglobin (p = 0.39) were observed. AS group had significantly higher blood pressure (p < 0.05) and lower eGDR (p ≤ 0.001) compared to NS and PS. Significant difference was also detected between PS and NS in systolic and diastolic (p = 0.02) pressure and eGDR (p = 0.01). In a multivariable model adjusted for age, gender, BMI and physical activity, smoking habits did not maintain any independent association with metabolic parameters.
This is the first study in a Mediterranean population, looking at tobacco smoke and cardio-metabolic factors in youth with T1D. The relationship between smoking and unfavorable metabolic profile was demonstrated. On the basis of these findings, smoking tobacco should be considered an important modifiable risk factor for young patients with diabetes mellitus, highlighting the need for intensified smoking prevention and cessation programs.
评估1型糖尿病（T1D）患者吸烟与代谢参数之间的关系。
我们纳入了104例T1D儿童和青年（50名女性和54名男性）（年龄16.4±8.6岁）。根据吸烟习惯将受试者分为三组：不吸烟（NS）、被动吸烟（PS）、主动吸烟（AS）。参与者的体格检查包括通过人体测量法评估营养状况、根据马歇尔和坦纳标准评估青春期阶段以及测量血压。对所有患者进行代谢血液检测，包括空腹血糖、胰岛素、总胆固醇、高密度脂蛋白胆固醇和甘油三酯。通过葡萄糖处置率（eGDR）确定胰岛素抵抗。还记录了身体活动情况。
三组之间在生化和功能参数方面存在显著差异，尤其是收缩压（p = 0.002）、舒张压（p = 0.02）和eGDR（p = 0.039）。未观察到每日胰岛素剂量（p = 0.75）和糖化血红蛋白（p = 0.39）的差异。与NS和PS组相比，AS组的血压显著更高（p < 0.05），eGDR更低（p≤0.001）。在收缩压和舒张压（p = 0.02）以及eGDR（p = 0.01）方面，PS组和NS组之间也检测到显著差异。在对年龄、性别、BMI和身体活动进行调整的多变量模型中，吸烟习惯与代谢参数没有保持任何独立关联。
这是在地中海人群中首次针对T1D青年的烟草烟雾和心脏代谢因素进行的研究。证明了吸烟与不良代谢状况之间的关系。基于这些发现，吸烟应被视为年轻糖尿病患者一个重要的可改变风险因素，凸显了加强吸烟预防和戒烟项目的必要性。
